CJ
Carika J

1 reviews | Active since Jul 2015

06 Nov 2018, 18:56

Fedhealth confused over claim vs benefit

I have been a loyal member of Fedhealth for a number of years.

I received a rejected claim from my GP (which is on the network list).

When I queried the reason it was rejected, since we are meant to have unlimited visits to a network GP. The call centre first told me that my savings were depleted - at which point I pointed out the unlimited Network GP visits....

He asked me to please hold while he checks. The he comes back and says that the reason they rejected the claim was due to this service only being claimable "once in a lifetime".

At first I thought it was a prank... and then I was told that it was not....

I find this absolutely unbelievable since my daughter is registered for Concerta on chronic benefit. And since Concerta is a schedule 6 medication the law states that the medication cannot be supp**** on a repeat script - a new script must be obtained from your doctor EVERY month....

I would like an explanation in regards to this as I pay an astronomical amount of money every month. Should I not receive valuable feedback and a proper explanation, I will be referring this to the FSB.

0
Replies (3)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply07 Nov 2018, 10:24
Official
Thank you so much for your review we will be in touch shortly. 

Kind Regards
 The Fedhealth Online Team
CJ
Carika J's update10 Nov 2018, 12:22
Reviewer Update
An agent from Fedhealth phoned me back, but as I was in a meeting at the time, I missed the call. The person left a message simply stating "This is ... from Fedhealth in regards to you complaint on Hellopeter" No number, no other call, nothing. Seriously disappointed!
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply03 Dec 2018, 10:47
Official
A consultant has been in contact with you and detailed feedback has been provided. 

Kind Regards 
The Fedhealth Family